The effectiveness of different metabolic therapeutic regimens in promoting increased survival of severely shocked animals will be studied. The metabolic basis for effective agents will be probed. The abnormal metabolic state following the severe trauma of hemorrhagic shock will be studied by determining the role of adrenal and pancreatic hormones in conditioning changes in insulin action on blood substrates, hepatic and leg metabolite balance and total body nitrogen balance. Clinical studies will be carried out to establish the effect of trauma on forearm metabolite balance before and during insulin infusion, to measure the insulin related metabolism of fat and muscle tissues obtained at surgery, and to test the effect of injected insulin in blood energy substrates and amino acid levels.